Question

Using current research and scholarly information (within the last five years), identify and analyze at least two key areas of disparity in healthcare.

What economic policies do you think economic policies have impacted these disparities?

What recommendation related to each disparity would you make for an organization to plan for this to minimize the negative impact while still delivering quality care?

Answer 1

Health disparities, which are sometimes referred to as health inequalities, have garnered an increasing amount of attention from physicians and health policy experts, as well as a renewed focus from federal health agencies. As a complex and multi-factorial construct, differential access to medical care, treatment modalities, and disparate outcomes among various racial and ethnic groups has been validated in numerous studies. The antecedents of such differences involve such "drivers" as cost and access to the healthcare system,primary care physicians, and preventive health services. In addition, the subtle role of bias in creating and/or exacerbating health disparities is well documented in the literature.

The Significance of Racial and Ethnic Disparities in Healthcare

Racial and ethnic disparities in healthcare are important for a number of reason. They pose significant moral and ethical dilemmas for the U.S healthcare system. As a nation, we have an abundance of healthcare facilities, cutting edge technologies, and oharmacotherapeutics and other assets that are the envy of the world, but which are not acesssible for myriad of reasons to all segments of the population. Also, healthcare as a resource is tied to various notions of social justice,opportunity, and quality of life for our patients, our communities, and the nation at large. A closely allied concern is thenation's economic well-being, which is both directly and indirectly tied to the health status of our population in general, and of specific population groups in particular. As a result, inadequate, inaccessible, and/or poor medical care further exacerbatess increasing healthcare costs that have broad implications for the overall quality of care experienced by all Americans.

Evidence garnered over the past 3 to 4 decades is compelling. Health and disease states are unevenly visited upon various population groups. A few examples are illustrative:infant mortality for black babies remains neraly 2.5 times higher for white babies; the life expectancy for black menand women remains at nearly 1 deacde fewer years of life compared with their white counterparts;diabetes rates are more than 30% higher among Native Americans and Latinos than among whites;rates of death attribytable to heart disease,dtroke, and prostate and breast cancers remain much higher in black populations, and minorities remain grossly under-represented in the health profession's workforce relative to their proportions in the population.

Health Disparities Defined

Health Disparities are differnces and/or gaps in the quality of health and healthcare across racial,ethnic,and socio-economic groups. It can also be understood as population-specific differences in the presence of disease,health outcomes, or acess to healthcare. Health Disparities are racial or ethnic differences in the quality of healthcare that are due to access-related factors or clinical needs,preferences, and appropriatebess of intervention. Lifestyle choices,age,sexual orientation, lack of access,and personal, socio-economic, and environmental characteristics are also to be included.

Disparities in Cost and Affordability

A plethora of data further emphasises a major contributor to the problem of health disparities: the cost and access to many Americans for obtaining the medical care they require. Clear disparities exist in rates of health insurance coverage among black and Latino population groups. The consequences of being uninsured are significant and include use of fewer preventive services,poorer health outcomes,higher mortality and disability rates,lower annual earnings because of sickness and disease,and the advanced stage of illness. Thus, the insured tend to be disproportionately poor,tound, and from racial and/or ethnic minority groups. An analysis by the Joint Centre for Poltical and Economic Studies and Johns Hopkins University explored the economic burden of health inequalities for minorities would have reduced total costs by approximately $1.5 trillion over a 3-year period.

Why Health care Disparities are a concern?

One in three residents of the United States self-identity as either African American,American Indian/Alaska Native,Asian, Native Hawalian/Pacific Islander, Hispanic/latino, or multiracial. By 2050, this number is expected to increase one in two.

Despite significant advances in civil rights,race remains a signifcant factor in determining whether an individual receives care,whether an individual receives high quality care, and in determing health outcomes.

The Institute of Mediccine (IOM) landmark report, Unequal Treatment, provides compeeling evidence that racial/ethnic disparities persit in medical care for a number of health conditions and services.

Addressing Health care Disparities

Although attention to racial/ethnic disparities in care has increased among polivymakers, there is little consensus on what can or should be done to reduce these disparities.

The four broad policies for addressing racial and ethnic healthcare disparities:

• Raising public and provider awareness of racial/ethnic disparities in care:
• Expanding health insurance coverage
• Improving the capacity and number of providers in underserved communities; and
• Increasing the knowledge base on causes and interventions to reduce disparities.

Raising Public and Provider Awareness

Perceptions of a problem often influence the actions taken to change policy and practices. If the public or providers are unaware that a problem exists, or misunderstands the nature of the problem, it can be difficult to direct resources to address that problem.

Efforts to raise public awareness of racial/ethnic healthcare disparities have achieved modest sucess.

Expanding Health Coverage

Health Insurance matters deremining whether and when people get necessary medical care,where they receive care, and how healthy people are. However, racial/ethnic minority populations-who constitute only about one-third of the U.S population-are disproportionately represented among those without any health coverage.Compared with the insured, the uninsured are less likely to have a regular doctor or to get timely and routine care, and are more likely to be hospitalised for preventable conditions. Thus expansions to health insurance coverage are of particular importance to racial/ethnic minority groups.

Improving the Number and Capacity of Providers in Undeserved Communities

Despite efforts since the 1970s to increase the number of health proffessionals in medically undeserved areas, members of racial/ethnic minority groups are still underrepresented in the health care workforce and are more likely than whites ti live in neighbourshoods that lack adequate health resources.

Even when health care resources are geographically accessible, language and cultural barriers are sometimes a problem. Approaches to strengthening communication and relationships between patients and providers include greater use of medical interpretation services,expanding the racial/ethnic diversity of the health professions workforce, developing provider training programs and tools in cross-cultural eduaction.

Increasing the Knowledge Base

Although evidence of racial and ethnic healthcare disparities is substantial, the evidence-base for developing interventions to eliminate these disparities remains limited.Increasing the knowledge base will require investing in routinely collecting an analysing data on health care use across racial/ethnic groups. Date from national survey, health insurers, and different health settings are neede to better understand the problems and impact of interventions. One reason we know so little about patterns of health care use for many racial/ethnic groups is that we have not collected the data or have insufficient sample sizes in publicly available data sources.Yet, at a time when the heterogenity of the population is increasing, funding for national surveys that measure disparities and track the nation's progress in addressing them is being cut.